Permit C ITY OF TIGARD PLUMBING PERMIT
� �r 4 DEVELOPMENT SERVICES PERMIT #: PLM2000 -00283
-°7•:)J1 13125 S W Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/02/2000
SITE ADDRESS: 12159 SW QUAIL CREEK LN PARCEL: 2S103C6 -10800
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 066 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
DON MORISSETTE HOMES PRMT JMT 08/02/200C $25.00 0004167
4230 GALEWOOD STREET
5PCT JMT 08/02/2000 $2.00 0004167
SUITE 100
LAKE OSWEGO, OR 97035 Total $27.00
Phone 1: 274 -5223
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
•
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 00006136
PLM 11558
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature: 0—e._.
Call (5 ) 639 -4175 by 7:00 P.M. for an inspection needed the next business day •
06/06/99 TEE 10:57 FAX 503 598 1960 CITY OF TIGAIW
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CITYOF TIGARD Plumbing Permit ApplicatiodRECEIVF^ Plan CrecX S
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13125 SW HALL BLVD. . Commercial and Residential . Reed By
TIGARD, OR 97223 . JUL 21 1 2n .-..r Da:a Reed
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(503) 639-4171 .. . " Da:e to P.E.
• Print or Type . COMMUNITY DEVELu, Date to 03T . • •
Incomplete or illegible applications will not be accepted Pem4* P --- /M 9-4D6-6v2- 6 3
• Related SWR S -
. . . 1 •,&f: Cacti •
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. - - . •
Name of Deveiopment/Projec: . 'igPP.J.g.g,1c164,41111VR'74q::-..-"F.P:W.; IPTY, ;;;F EtIC Et:1,07.g: . - •
Job • at,k_etzt- 6kotlolo Lo 7- ( e ° .
sok • 11.50
_
Address Str.t Address 1 . 1 Lavatory - . 11.50 . -
• Toll S Stij ()L L Tub or Tub/Shower Comb. 11.5C .
- • - - • - - - -.- .81dg # I C' /State • • -- - -- Zip_ - --- -• -.- • --- • -
Shower Only . . 11.50
...
Name . -
. Water Closet ., • • 11.50
• . -.
. bern Merrissdic. Harries Dishwasher .
- • ... . " • . .
. • • /4.:.e4":
• Owner Man Address Suite • Garbage Disposal - • " • 11.50
1/Q3o Sly Geliewcoct. .
- Washing Mad** . 11.50
City/State Zip Phone
• Ltaec bSuicya ore, 79o- to V 5-0 Floor Craln/Floor Sink 2 . . 11.50 •
• Name\ . . • • 3° . • 11.50 - -
- • .
• 4' ' 1 1 . 50
Occupant lialling Ad . ss Suite _. Water Healer 0 conversion 0 Ike kind , 11.53
Gas piping requires a separate maChanical pnnft.
• . _ •
e '
•
• Cfty/State Zip Phone - Laundry Room Tray .11.53
. -.
Urinal 11.53
!tame -. • . . • • • i- Other Fixtures (specify) '
- 041CISC.a.p...
- • - Pro GrAss Lotridsz e,
Contractor Wiling Address . S uite . .. .... •
21 PI 5 9.0 kint . . . . ... .
. •
.
Pricr to permit City/State Zip Phone bp- -- -_,. sewer- 1st 100 38.00
- Issuance. a copy WO Sin Wik Ott. Vcrlo /A0140 -7 - : - . • - .. , - •
Sewer - each additional 100 32.00
-
of licenses are ()regal] COn3t. Cont. Board Lk.* ... E.43. Date • -• • -.. -
required if . • - (i43-( .. 1 813 / j0c, p ....- Water Service -1st 100' • . •
expired in COT Plumbing tic. t Exp. Date . - Water Service - each additional 200 . •=-:,7. '• 32.00 , •-• ...,:' .:;-:•.;:-.-,..
• - ' • -:.
. database • Storm & Rain Drain- 151100
Name ' • • • •
. ., .
.. . . .
. . - Storm & Rain Drain -, each additional 100' 32.00 • _ • --
. ..
Architect • '.. • . ' • Mobile Home Space - • • 3200
• or - Mailing Address • Suite - Commercial Back Flow Prevention Device or Anil- . , 32.00 ' ' •
• , ••_
• . Pollution Device
• Engineer atOtate Zip Phone Residential Bacidlow Prevention Device' . 19.00 /VCR '• e ''
• (InIgatior tirrinc devices require a separate
Describe work to be done: . restricted energy permit) -
New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture • 11.50 . •
Residential 0 Commercial 0 Catch Basin 11.50 -
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Additional description of work: . •
Insp. of Existing Plumbing 50.00 j
• per/y
• Specially Requested Inspections • - 50.00 I
Are you capping, moving or replacing any fixtures? per/ir •
Yes 0 No 0 Rain Drain, single family dwelling 45.00
If yes, see back of form to indicate work performed by
Grease Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. . TOTAL
1 'i,:r. - f •-•
I hereby acknowledge that : have read this application, that the information Isomeric cr rise/ &Gram Is rill:grad If Quail* Tetal Is s• 9 _1" ... _ :4 P . . ... .. ..
given Is correct, that I arm the owner or authorized agent of the owner, and *SUBTOTAL
• that plans submitted are in compliance with Cregon Stale Laws. = '• • 7 '.'::•"ire , '
=ettSv gent Date , 159. IS% SURCHARGE :.:::: :•
• if:5 ' iV:f-a
Contact Person Nerd Phoni "'PLAN REVIEW 25% OF SUBTOTAL rIll'Hglii;;I:t:'::::`.:i
• Requimd Drib H tam qty. kb:1113. 9 !
NOMRIPUSZSIPP-Cii:PZII:rittigiii*.44tif.-N-1.11fatg--r_i TOTAL . f2-::] ' .!::'::41
taNnOgralZgqi-iikij.:iTil*-`;fflanl--2.13.VISNIFIACV±Rgrl .. '
t.:-:-L._..110,01...1*(39:erigrEall-ZOIMV....55:7§:-€-;,72-11;ri 'Minimum permit fee is $53 + 5% surcharge, except Residential Backftow
if_ .17#13.119t-ggitiW.Paitt,...N.Wfiftialliti,A0Ifitaf-itklisairia=LF413 -- Pr_s_.reMionLli .d.__,A1.,,ece "htsia5 , 5% eurch ere e
Ltit,....04-Vekairitriibitaitiktef_VOntsregiartifylitt_°41:r-I'M "All New Commercial Buildings require plans with isometric or riser diagram
and plan review
LicIstsnrrnapiumapp.dc: VAS
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 , ,,Z,UVU —6 e)2
Date Requested e- AM PM BLD
Location /2-/ 5e-v aft(( 01,.x -ex Suite MEC
Contact Person Ph 4'S') ? PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PAS RT FAIL
LUMBIN
Post & Beam
Under Slab
Top Out e N
Water Servic
Sanitary Sewer
Rain Drains
F ASS PART FAI
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date - y- d Inspector ��. ✓ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION (\/ MST
24-Flour Inspection Line: 639 -4175 Business Line: 639 -4171
95 BUP
Date Requested — Y AM PM BLD
Location /2 Sw 6 / Suite ME
Contact Person Ph C ' - 76 PL 6p3
Contractor Ph Q k t 7 SWR
BUILDING Tenant/Owner ELC ll
Retaining Wall ELR I
Footing Access: • F PS �� ����� w
Foundation �
Ftg Drain SGN Ware
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASHA T FAIL
UMBI
os & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Ra' ' . ! rains
CI( tiGK -•
6 0 PART FAIL
ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date Inspector Ext
Other
Final •
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.